Course Co-ordinator: Dr. Nicolene Lottering
Location: Room N322, Level 3, Medical School North 
Tel: +61 8 8313 5342
Email: nicolene.lottering@adelaide.edu.au

Course Email: msk_admin@adelaide.edu.au

1	Identify and annotate skeletal structures of the axial and appendicular skeleton, including landmarks of muscle attachment, and describe the type, structure and function of bones.
2	Describe the detailed anatomy of the muscular, nervous systems and vasculature of the upper and lower extremities, abdominopelvic region, vertebral column and head and neck, on human cadaveric specimens and cross-sectional images.
3	Relate the biomechanics of the musculoskeletal system, at the micro and macro levels of organisation, to human movement and mechanisms of injury and disease.
4	Differentiate types of joints and their macroscopic anatomy, including major ligaments, connective tissue structures and bursae; explain and recognise high-incidence joint injury and pathology on principal imaging modalities
5	Explain and demonstrate the concentric functions of limb muscles based on knowledge of its origin and insertion, the joint that it crosses and direction of fibres.
6	Summarize the regional and compartmental innervation of major nerve plexuses; and describe the causes, functional changes in movement and clinical assessment associated with lesions and plexopathies.
7	Predict the movements available in each vertebral column region and the describe the functions of the abdominal, pelvic and back muscles.
8	Name, identify and locate the muscles of facial expression, mastication, and the anatomy and function of the temporomandibular joint.
9	Discuss how skeletal, muscular and nervous system structures are affected by exercise, immobilisation, disease, growth and development and degenerative conditions.
10	Reduce a complex functional problem to basic principles and explain the mechanism of the problem in lay terms by working in small groups.

1. Atlas of Clinical Gross Anatomy, 2nd edition, 2005 by Kenneth Prakash Moses et al., published by Saunders (imprint of Elsevier). ISBN: 978-0-323-07779-8
2. Basic Biomechanics of the Musculoskeletal System, 2012 by Margareta Nordin and Victor H. Frankel, published by Wolfer Kluwer/Lippincott, Williams and Wilkins. ISBN: 978-1-6091-3335-1.

Supplementary Texts (Available on ClinicalKey Australia 2012)

1. Manual of Structural Kinesiology, 19th edition, 2014 by RT Floyd and Clem Thompson, published by McGraw-Hill Education. ISBN 13: 978-0-07336-929-7
2. Netter’s Introduction to Imaging, 2012 by LR Cochard, published by Saunders (imprint of Elsevier). ISBN: 978-1-4377-0759-5.

This course will use Canvas as an eLearning platform for the dissemination of lecture notes and recordings, tutorial activities, and deployment of summative quizzes. Course content will be subdivided into modules in Canvas; each with folders disseminating copies of the didactic lecture notes, articulate storyline lectures, anatomy resource session notes; as well as folders with formative and summative assessment tasks relevant to each module. This course will also encompass blended learning approaches using innovative teaching styles including lightboard technology and videoscribe conceptional multimedia. Canvas will be used as the primary platform for announcements, the integration of learning pathways and to deploy student update emails. A closed-group facebook page for the unit will be developed to encourage discussion, communication and resource sharing between students.

The course curriculum is segregated into introductory lectures and four content modules, divided by anatomical region. Specifically, students will be: introduced to the basic concepts of biomechanics, the macro and micro-structure of soft and hard tissues of the musculoskeletal system (MSK), followed by common radiological modalities and their radiographic interpretation associated MSK anatomy and pathology, including plain radiography, multi-slice computed tomography and magnetic resonance imaging, in the introductory module. This will be followed by segregation of MSK regional anatomy, including the osteology, arthology, neural, muscular and vascular systems for the (1) upper and (2) lower limbs; (3) trunk (including the pectoral region, anterior and posterior abdominal walls and vertebral column); and (4) head and neck. Content for each module will be delivered using a blended/hybrid teaching and learning approach, with approximately 4-5 didactic lectures, as well as a compulsory case-based learning workshop each week to apply concepts to a real-world, clinical context based on common MSK fractures, soft tissue injuries (strains, sprains and dislocations), nerve impingements and emerging technologies, pertaining to each anatomical region. The pedagogy associated with this unit is characteristic of a spiral curriculum, revisiting introductory topics (osteology and neuromuscular systems) covered in year 1 and extending towards topics covered in year 3 i.e. “Applied Clinical Anatomy” which will cover sectional anatomy, radiological interpretation and patient assessment. In the spiral curriculum, knowledge is presented in a logical sequence from simple to complex, evidenced through the integration of advanced anatomy themes i.e. cross-sectional and anatomical imaging.

The weekly anatomical resource sessions are designed in a form of team-based collaborative learning that incorporates small group activities at each content station and a summative assessment station. It is anticipated that students will have an enhanced learning experience through the use of team-based learning and peer teaching. The resource sessions are intended to extend and amplify student understanding of material presented in lectures in an interactive format, where they are given opportunities to seek clarification on any aspect of the topics covered, as well as to tackle concepts that might be difficult to grasp. Students will be exposed to cadaveric material, anatomical models, surface anatomy and medical images; combining a traditional “wet-laboratory” with interactive multimedia activities using the Ray Last Anatomy cameras, projectors and whole-class presentation system. In addition, students will also gain an understanding of the three-dimensional spatial arrangment of the human body using state-of-the-art virtual and augmented reality technologies and software in this course. Attendance and grading in each resource session will be electronically conducted using the SpeedGrader tool in Canvas.

Students will also be required to complete formative assessment in the form of weekly spotter tests or online quizzes for each module, designed both to test students understanding of the content and to reveal to them what information may need further revision. This assessment will encourage students to keep up with the material throughout the course, and provides an opportunity for continual feedback. Select questions from the online quizzes, formatted to include multiple choice, fill-in-the-blanks, hot spots and short response type questions, will be included in the End of Semester theory exam.

Teaching sessions include two didactic lectures per week; while in some weeks an additional online articulate storyline lecture will be disseminated to students, depending on the availability of guest lecturers (university affiliates, clinicians etc.). The online lectures will be regularly available for flexible access by students, posted on Canvas each Monday afternoon, while the didactic lectures will be timetabled, recorded and disseminated using Echo360. A blended learning approach to didactic lectures will be implemented using live polling in-class via. Mobile, ipad and laptops. Students will also be required to attend a 1.5-hour laboratory session each week, which presents an opportunity to develop and test their understanding using models, human cadaveric prosections, skeletal material and medical images (conventional radiographs, MSCT, MRI), in the Ray Last Anatomy Laboratory. In order to implement active learning clinical presentation (CP) based curriculum in the laboratory sessions, students will be divided into small groups, each of which will rotate through a number of anatomy stations, designed with reference to the module/theme of the week, to address gross anatomy, procedural anatomy, functional anatomy and anatomical-radiological correlation components. For this to run successfully, each laboratory session will be capped at 60 students; mandating that the cohort be subdivided into three learning groups, to run three repeat laboratory sessions. Access to the multimedia management system in the laboratory is essential for utility of the inbuilt cameras, projectors and HDMI link to the monitors for small group demonstrations and activities. A demonstrating team with advanced gross anatomical knowledge and imaging experience (including PhD and MBBS students, clinicians) will facilitate and work alongside students in these sessions under the cognitive apprenticeship model. Students will be required to complete four online multiple-choice tests using the Canvas learning platform at the conclusion of each module. Formative assessment will also be conducted within the anatomy practical sessions using cadaveric specimens, medical images and clinical examinations, with attendance and grades uploaded via SpeedGrader in Canvas. 

N/A

SGDE will feature through summative group learning activities integrated in the Anatomy Resource Sessions each week and an “Anatomical Dialogue” Group project. At the commencement of this course students will be divided into three laboratory groups and each laboratory group subdivided into six teams, each consisting of ten students. Each team will have a mixture of abilities and backgrounds. The aim of this teaching approach is to enhance the learning experience through the use of individual and team quizzes and peer teaching and discussions. In each laboratory session, students will be required to complete a quiz constituting spotter and problem-based learning questions as a team, and submit their consensus answers to their demonstrator. The demonstrator will guide students through the answers, encourage discussion and provide clarifications regarding of the challenging questions and concepts. Some of the laboratory sessions will have additional tasks to be completed on a worksheet in your course manual (made available on Canvas prior to the session). These in-class quizzes, which are dependent upon student attendance, will contribute to 10% of the final grade.         
         Further, students will be required to work in groups of five (self-allocated) to complete a multimedia “Anatomical Dialogue” group project, which aims to explain the regional and functional anatomy of a nominated injury or medical condition of the musculoskeletal system disseminated in the modern media/sports broadcasting. Students will be required to critically evaluate anatomical dialogue used or lack thereof, in the original voice-over of the commentator/presenter explaining the potential injury; and provide alternative dialogue to better explain the injury to a layperson and medical professional, in the form of a video submission. As part of the submission, students will be required to provide a confidential peer-assessment of each group member’s contribution to this project using Canvas, for normalisation of individual grades. 

Assessment Task	Task Type	Due	Weighting	Learning Outcome
SAQ Quiz	Summative	Week 5 (in allocated Workshop)	5%	LO1-9
In-Semester Practical Examinations	Summative	Weeks 6 and 10 Prac Sessions	20% (10% each)	LO1-9
Anatomical Dialogue Group Project	Summative	Friday, Week 12	15%	LO3-7, 9-10
EOS Theory Examination	Summative	Central Examination Period	35%	LO1-9
EOS Practical Examination	Summative	Central Examination Period	25%	LO1-9

Attendance and active participation in the Anatomy Resource Laboratory each week is compulsory and collectively accounts for 10% of the total grade, if the student attends all workshops. Medical certificates or statutory declarations, providing a legitimate excuse for absence, are required for a student not to be penalised for non-attendance.

Assessment Item	Assessment Detail
SAQ Quiz (Online)	Upon the conclusion of the Upper and Lower limb modules, students will complete an online short-answer response style quiz, under the ‘Quizzes’ tab on the MSK Canvas site which comprises of TWO clinical stem questions with multiple parts, consistent with the formatting of the EOS Theory Examination – 5% weighting.
In-Semester Practical Examinations	Two in-semester practical examinations will be held during the allocated laboratory session in the Ray Last Anatomy Laboratory (SB02), which will cover a combination of lecture material, laboratory material and supplied onlineresources/readings. The format of the exams will contain approximately 30-35 stations, with 75-second rotations between each; these exams are designed to determine students’ ability to identify osteological, arthological, nervous and vasculature structures of the anatomical regions covered over the course of the semester, and their respective function. These examinations will be scheduled for weeks 4 and 9 of semester, which allows students to test their understanding, identify knowledge gaps and seek continuous feedback on their performance, under ‘spotter-format’ examination conditions. Students will be given a total of 45 minutes to complete each exam – 20% combined weighting
Anatomical Dialogue Group Project	General Objective: Demonstrate higher processing skills in the areas of synthesis and evaluation through an analysis of how anatomy is used and represented in our personal lives and future profession Description: Since sporting injuries are frequently discussed in modern media broadcasting and sports coverage, in groups of five, students will be required to source video footage relating to an injury or medical condition relating to the musculoskeletal system. Using this footage students will (a) reflect and critique the anatomical dialogue used or lack thereof, in the original voice-over of the commentator/presenter explaining the potential injury (i.e. comment on the accuracy, intended target audience, depth of the explanation); and (b) provide alternative dialogue to better explain the injury to a layperson with no anatomical training. In the second part of this project, students are required to provide an advanced overview of the regional anatomy i.e. muscle/nerve innervation/ vasculature likely to be affected with the injury and discuss the functional implications, targeted at medical professionals or anatomists. Part B: As part of the group submission, students will be required to provide a confidential peer-assessment of each group member’s contribution to this project using Canvas grading. Specifically, students will rate each member’s contribution on a scale of 0 – 5 for each of three to six criteria; scores will be normalized to give a final group contribution weighting between 0-1, which will then be multiplied by the product/overall mark of the group - 15% individual weighting
EOS Theory Examination	The 2-hour written examination is aimed at ascertaining each student’s understanding and knowledge of the principles and core course content presented during all modules and will be held during the university’s official examination period. The format of the comprehensive exam will include: Key style MCQ   Short answer questions (selective questions sourced from weekly practical notes) Extended response/Essay questions The time allocated will be 120 mins, plus 10 mins of reading time, but many students should be able to complete it in less than this; the additional time is provided to enable planning and review of answers – 35% weighting
EOS Practical Examination	The practical examination will be held in the central university examination block, in the Ray Last Anatomy Laboratory (SB02), which will cover a combination of lecture material, laboratory material and supplied online resources/readings. The exam is designed to determine students’ ability to identify osteological, arthological, nervous and vasculature structures of the anatomical regions covered over the course of the semester, and their respective function. The format of the exam will contain approximately 45 stations, with 75-second rotations between each; you will be required to answer short response questions using an amalgamation of cadaveric prosections, anatomical models and medical images. These questions may include identifying structures, explaining the function(s) of particular structures, labelling or drawing diagrams. Students will be given a total of 60 minutes to complete the exam – 25% weighting

Submission Guidelines for the Anatomical Dialogue Group Project:       

To be saved and submitted as a digital file (mp4 format or equivalent) with accompanying script. The maximum presentation time for each group should not exceed 15 minutes. File size should not exceed 500MB. To be submitted under the ‘Assessment’ in Canvas AND emailed to msk@adelaide.edu.au by the due date. Group contribution peer grading will be conducted online, individually and confidentially in Canvas – 15% weighting (individual).                                              

NOTE: We encourage creativity and originality with this task! Note that the marking criteria will include the ‘use of creative writing style’ so it is important that students write in a manner that makes their story interesting to read/watch/listen to.

2017 SELT FEEDBACK
Overarchingly, in 2017 the course fail rate and student satisfaction continued to improve since, dropping to 17%, whilst the broad agreement pertaining to the quality of the course improved to 91%. This may be attributed to the structural changes made to the learning pathway (content and modular restructure), re-organisation of gross anatomy laboratory sessions (increased duration of station rotations, with formative spotter examination each week) and introduction of the Alliance in Anatomy: Peer Leadership Program. Correlated to the reduction in fail rate, student engagement and satisfaction improved between 2016 and 2017, with increased broad agreement in all six individual performance criteria, most substantially for T03 (stimulates my interest in this course) and T04 (gives clear explanations) which verifies an increase in teaching experience, performance and capacity of the course coordinator. Student written feedback can be clustered into three-broad themes below:

Best Aspects of this Course:
Theme: Innovation and Engagement
• “Extremely interesting. It's not like a course i've ever done. So interactive which helps me a lot with my learning as I am a visual learner. The pracs are amazing, they go hand in hand with the theory perfectly. The facebook page makes for such a perfect discussion board”
• “The course is well-organised and (for the most part) deeply engaging. The assessment structure accounts for the fact that studying anatomy is an 'all or nothing' approach - it's much easier to understand earlier once you have completed the course, and can take a 'big picture' approach. This course encourages intelligent usage of resources, including textbooks, videos, cadavers, apps, and the student's own body. Access to ClinicalKey was a hugely valuable resource. It is a deeply challenging course, but I am pleased to have taken it and would recommend it to future students.”
• “The best aspects of the course is the fantastic course coordinator and the amount of interaction we have with staff and peer mentors. There is a lot of encouragement provided to students and different methods of assessment that help me with learning content.”
• “The fact that in every class it is engaging. The lecturers are always interacting and dropping little bits of information that are extremely helpful with specific ways to remember them”
• “Extensive interactivity: practical sessions, VR, lightboard.”
• “Nicolene. She is very engaging, enthusiastic and helpful. The practicals were very helpful. Virtual Reality IS INCREDIBLY HELPFUL.”
• “The range of resources is great, provides lots of different ways to study. As well as all the interactive classes where we draw out nerves or blood supply.”
• “The online resources, Facebook, snapchat, student resources were also good - it's nice to know that there are a few options for where we can get information.
• “The way in which the course encourages and is so supportive of different learning strategies; understanding people have different ideal learning strategies, the way in which they provide a variety of study methods and strategies for all students go utilize. examples The labs, VR, interactive lectures, Facebook page for ideas and much more.

Theme: Practicals and Formative Assessment
• “It was the best course of this semester. It taught me a lot and was very practical and hands on.”
• “I also found it really helpful to have station 6 set up as a mock spotter exam - it helped us get used to spotter exams and thinking on the spot. Just a suggestion, maybe at the end of every major module, dedicate 15-20 mins for us to go look at the cadavers and familiarise ourselves with all the structures - I found it very helpful doing this at the end of the semester and would've appreciated if we'd had the chance to do it before.”
• “Best part is the labs. Obviously to see and touch the cadavers is the best learning tool. However, at times it's difficult to see some parts, but the tutors informed us of that anyway.”
• “Practicals were a highlight of this course and were where I learnt most of the content as it put everything into perspective and was more interactive than learning through lecture slides.”
• “Practicals - Up close and personal with specimens and demonstrators that expand your knowledge and provide different perspectives on the content.”
• “The best aspect of this course was the practicals every week where we were able to use the specimens to go through the content we had learned throughout the week. Which helped in understanding the content better.”
• “The practicals allow us to see all of the concepts that we learn in the textbook in a real life structure. It also allows us to as any of the peer leaders advice with learning strategies or concepts that we don't understand.”
• “The best aspects of this course is the practical sessions as they are really informative. Looking at cadavers also very much helps consolidate the topics and concepts learnt in the lectures. One of the other best aspects of this course is they way it's planned and the way information is presented. It has a mixture of different teaching techniques that really help to foster different styles of learning, which is great!”

Theme: Peer Leaders and Teaching Team
• “The facebook group page was excellent and provided a go-to resource to ask questions and Nikki and the peer leaders were really good at answering questions promptly and with great detail.”
• “Great staff, lecturers, peer leaders, prac instructors, Nicolene is a boss”
• “The resources available to us (Ray Last lab). Nicolene was the best and peer leaders also helped with learning.”
• “Nicolene is an amazing and very supportive coordinator and the content is very interesting.”
• “Engaging content and involved staff, a team atmosphere with great use of social media and online resources.”
• “It is very good that we have peer monitors to help us to understand the contents and give us many awesome ways to learn this”
• “The best aspect of this is course peer mentors, tutors, teachers because they are willing to help and answer any questions.”
• “Having peer mentors and demonstrators were helpful and also using various social media to engage us with the content”
• “The best aspect of this course is Nicolene. I love her lecture slides, her teaching style and her youtube videos were extremely helpful. 10/10 teaching”
• “I really enjoyed the peer mentors in this course as well as the effort Nicolene has gone into to incorporate various types of resources such as NetAnatomy, snapchat revision and youtube anatomy videos. It has really helped to cement the content in other ways than the traditional lecture setting.”
• “There is nothing I could fault with this course. Everything is structured and organised in a way that engages the students thoughts. Nicolene is by far the best coordinator I've had thus far, her dedication to her students is amazing. I believe this course was well organised and managed to present the material in a way which was engaging and easy for the students to understand.”

Select Responses for “This course can be changed in the following ways…”
Theme: Upper Limb Lectures
• “UPPER LIMB MODULE - this module was very disorgazined and frankly, very very overwhelming especially since for a large majority of us, it was the first time every hearing 98% of those words. It made it very difficult to study this content and the learning outcomes, for the most part, were not covered in adequate detail in the lectures. The interactive sessions were useless and did not at all consolidate the information learned probably because the online lectures were a mess and it was not clear what was being talked about!!
• “Starting off with an established criticism: the recorded upper limb lectures did not work. Frankly, I still haven't watched them. They were a nightmare and we all fell behind”
• “The upper limb module could be changed as it was poorly organised. Perhaps including less content (say just upper and lower limb and back) or making the course worth 6 units would be advisable.”
• “Just keeping the format consistent - i.e. the Upper limb section was a little confusing, and was different to the other sections.”
• “Probably a very common point - restructure Ian's module so that more content is in the lecture notes and the learning outcomes are more clear.”

Coordinator Response and change for 2018 for this theme: Students were introduced to a ‘flipped classroom’ environment for this specific module; however since many students aren’t familiar with this format in first year, particularly the ‘pre-classroom’ component, this teaching technique did not seem highly effective as many students were unprepared in class. In addition, Articulate Storyline was used to deploy online material/lectures and unfortunately the students did not respond well to this modality as they were unable to pause/rewind/speedup delivery. In 2018, a didactic approach will be used to delivery content, in conjunction with a blending learning approach for the corresponding workshop using lightboard videos and interactive in-class activities i.e. anatomical sketching and surface
anatomy, to reinforce concepts.

Theme: Workload
• “Make the course longer or a first year course as well, there is just too much content and the time frame for which we have to learn all of contents! I love learning anatomy however this course is just so compacted and I would've been better equipped if there was a first year course for anatomy or making this a 2 semester long course. Like 1A and 1B etc”
• “If there could be more of an introduction in the first year of university that would help a lot instead of going in and not even knowing the osteology. Nothing in first year biology prepared us for this course so an introduction to anatomy would be very beneficial.”
• “A decrease in content, with many student having 3 other course, content quickly piles up and overwhelms students, I'd like to see the course split into 2 semesters”

Coordinator Response and change for 2018 for this theme: The number of negative comments and feedback pertaining to workload and content burden significantly improved in 2017; hypothesizing that clearer expectations, learning objectives and communication made the course more manageable. Although this is a very fast paced course, it has inherently and historically received this feedback over many years, but a restructure has not been possible at a program level. Dr. Lottering therefore submitted a proposal to the academic board in for a first year introduction to anatomy course, which provides an introduction to osteology, arthrology and musculature (see attached documentation), for likely implementation in 2019. The benefits of a proposed first year course in anatomy, as an elective are wide-reaching for years 2 and 3 of the BHMS.

Theme: Request for Tutorials/Workshops
• “It would be great to have a little question/explanation session after the first few weeks to explain how the course works, learning stratagies (ie not to take notes but instead to do flow charts and diagrams) and the level of detail we need to know (ie not to focus on origin and insertions but more innervations/blood supply, as i know a lot of people who spent a tonne of time before the first exam just trying to memorise them in great detail). It would really benefit to do this early so we can get into good habits and not get behind”
• “I wish there was a tutorial class which allowed for more discussion and that the course wasn't so intensely reliant on the lectures. The subject doesn't take into account that if you can't make it to one lecture a week you are already at a disadvantage.”
• “If a tutorial section can be set up to help to further clarify lecture contents and give us a chance to apply the knowledge in our real life.”
• “Perhaps introducing tutorials as well as practical to help breakdown the content covered in the lectures even more. Otherwise this course has been very enjoyable.”

Coordinator Response and change for 2018 for this theme: A weekly, compulsory workshop has been timetabled into Semester 1, 2018 for this course using a SGDE format to address and improve student competencies under a case-based learning curriculum. This will also allow extra, scheduled time for students to work on their Anatomical Dialogue Group Assignment in class.